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Diabetes: Should I Get Pregnant?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Diabetes: Should I Get Pregnant?

1

Get theFacts

2

CompareOptions

3

YourFeelings

4

YourDecision

5

QuizYourself

6

Your Summary

Get the facts

Your options

Try to get pregnant now.

Don't
try to get pregnant now.

Key points to remember

Is your blood sugar in a
target range for pregnancy? Women with diabetes who
want to get pregnant should have blood sugar levels in a target range before they get pregnant. (The American Diabetes Association suggests an A1c of less than 7% for most nonpregnant adults.footnote 1) This lowers the chance of birth defects,
miscarriage, and other problems. Check your blood sugar throughout the day to
see if it is in a target range. If not, consider using birth control until
your blood sugar is in that range.

Do you take pills to treat diabetes? Your doctor may have you
switch to
insulin or take a different pill before you get
pregnant. If you are changing to insulin or a new pill, make sure that the
medicine is controlling your blood sugar before you try to get
pregnant.

Do you take insulin? Talk to your doctor before you try
to get pregnant to see if you need to change your dose or how you take it (such
as through an insulin pump or as shots). If you figure out the right dose of
insulin to take before you get pregnant, you are less likely to have problems
with high and low blood sugar during your pregnancy.

Do you take
medicine to treat other problems? Talk to your doctor before you get pregnant
to see if you need to stop or change your medicine.

Do you have
problems from diabetes, such as eye or kidney disease? If you do, being
pregnant can make some of these problems worse. Also, high blood pressure can
create problems for you and affect your baby's growth during pregnancy.

Do you have other children? If so, how did the diabetes affect
your pregnancy?

Do you take a folic acid supplement? Taking a
daily multivitamin or prenatal vitamin with folic acid reduces the chance of
having a baby with a birth defect.

You can have a healthy pregnancy if your blood sugar is
in a target range before you get pregnant and you don't have
high blood pressure or problems from diabetes, such as kidney disease. Keeping
your blood sugar at a target level lowers your risk of birth defects,
miscarriage, and other problems. (The American Diabetes Association suggests an A1c of less than 7% for most nonpregnant adults.footnote 1)

The American Diabetes Association (ADA) suggests the following ranges for women with type 1 or type 2 diabetes who become pregnant:footnote 1

A1c: 6% to 6.5%

Before meals, bedtime, and overnight: 60 to 99 mg/dL

1 to 2 hours after meals: 100 to 129 mg/dL or lower

Experts recommend keeping blood
sugar levels in the target range for 3 to 6 months before you get
pregnant. To do this, get plenty of exercise, eat healthy foods, lose weight if
you need to, and take medicine if your doctor prescribes it.

Medicines

It's important to let your doctor know
if you are thinking about getting pregnant. If you take pills to treat your
diabetes, your doctor may want you to switch to insulin or to a new pill before
you get pregnant. And if you take insulin, your doctor may need to change the
dose or how you take it, such as through an insulin pump or as shots.

You also need to let your doctor know about any medicine you take to
treat other health problems. He or she may have you stop or change your
medicine before you get pregnant if you are taking any medicines that could
harm your baby.

Screening

When
you have diabetes, you need to see your doctor regularly to check for problems
from the disease. It's especially important to do this before you get pregnant.
Screening tests help your doctor look for these problems before any symptoms
appear. This can increase your chance of finding the problem at a more
treatable stage. These tests include:

Blood pressure checks. High blood pressure can
cause problems with the mother and the baby. When blood pressure is very high,
the
placenta may not work well and the doctor may need to
deliver the baby early.

Blood sugar level tests. Your doctor will talk to you about
keeping your blood sugar in a target range at all times before
and during your pregnancy.

You talk with
your doctor about your desire to have a baby. Working closely with your doctor,
you may be able to set a goal for managing your diabetes so that you can get
pregnant later.

You avoid the
risks of being pregnant while your diabetes is not controlled.

It
may be disappointing to not be able to have a baby when you want to.

Personal stories about deciding about getting pregnant when you have diabetes

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I have had
diabetes for a long time. So when my husband and I started talking about having
a baby, I mentioned it to my doctor during my regular checkup. I do a good job
of keeping my blood sugar under control. So after doing some tests and
adjusting my medicine, my doctor said it was safe to start trying. I got
pregnant and gave birth to a healthy baby boy.

Mandy, age 32

My life has
been pretty stressful, and it has been hard to keep my blood sugar in my target range. I want to get pregnant before I'm too old, but I worry about the risk of
birth defects if I get pregnant now. Having a baby is a priority for me, so I
talked to my doctor about some specific changes I can make to lower my stress
level and focus on my health. I am going to wait for now to see if I can get my
blood sugar under control.

Rachael, age 38

I have two children, and we want to try for
a third. I had diabetes with both my pregnancies. My doctor worked with me to
set target blood sugar levels before each pregnancy, and everything went
smoothly. I am now 5 months pregnant and feeling good.

Janelle, age 34

Recently I
was diagnosed with type 2 diabetes. I am newly married, and my husband and I
want to have a family in the next few years. I am taking medicine and trying to
eat right and get exercise so that I will be healthy when we decide that the
time is right to start trying to have a baby.

Christine, age
26

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to try to get pregnant now

Reasons not to try to get pregnant now

I am not worried that my diabetes will cause health problems for my baby.

I am worried that my diabetes may cause health problems for my baby.

More important

Equally important

More important

I want to try to get pregnant now. I don't want to wait.

I want to wait until my doctor says it is safe before I try to get pregnant.

More important

Equally important

More important

My blood sugar levels are under control, and I'm confident that I can keep them controlled.

I want to get my blood sugar levels under control before I try to get pregnant.

More important

Equally important

More important

I'm not worried that getting pregnant now could harm my health.

I am worried that getting pregnant now could harm my health.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Trying to get pregnant now

NOT trying to get pregnant now

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.1, As long as my doctor says my medicine is controlling my diabetes, it is safe for me to try to get pregnant.

TrueNo, that's not right. Having your diabetes under control isn't enough. To have a healthy pregnancy, you also need to make sure that you don't have high blood pressure or problems from diabetes, such as kidney disease.

FalseYou're right. Having your diabetes under control isn't enough. To have a healthy pregnancy, you also need to make sure that you don't have high blood pressure or problems from diabetes, such as kidney disease.

I'm not sureIt may help to go back and read "Get the Facts." To have a healthy pregnancy, you also need to make sure that you don't have high blood pressure or other problems.

2.2, My blood sugar levels should be in a target range for at least 3 months before I get pregnant.

TrueThat's right. You should have blood sugar levels in a target range for at least 3 months before you get pregnant. This lowers the chance of birth defects, miscarriage, and other problems.

FalseNo, that's not right. You should have blood sugar levels in a target range for at least 3 months before you get pregnant. This lowers the chance of birth defects, miscarriage, and other problems.

I'm not sureIt may help to go back and read "Get the Facts." You should have your blood sugar levels in a target range for at least 3 months before you get pregnant.

3.3, Before I get pregnant, I need to see my doctor regularly to check for diabetes complications, such as eye or kidney disease.

TrueThat's right. When you have diabetes, you need to see your doctor regularly to check for complications from the disease. These problems can get worse during pregnancy.

FalseThat's not right. When you have diabetes, you need to see your doctor regularly to check for complications from the disease. These problems can get worse during pregnancy.

I'm not sureIt may help to go back and read "Get the Facts." When you have diabetes, you need to see your doctor regularly to check for complications from the disease. Pregnancy can make these problems worse.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Diabetes: Should I Get Pregnant?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Try to get pregnant now.

Don't
try to get pregnant now.

Key points to remember

Is your blood sugar in a
target range for pregnancy? Women with diabetes who
want to get pregnant should have blood sugar levels in a target range before they get pregnant. (The American Diabetes Association suggests an A1c of less than 7% for most nonpregnant adults.1) This lowers the chance of birth defects,
miscarriage, and other problems. Check your blood sugar throughout the day to
see if it is in a target range. If not, consider using birth control until
your blood sugar is in that range.

Do you take pills to treat diabetes? Your doctor may have you
switch to
insulin or take a different pill before you get
pregnant. If you are changing to insulin or a new pill, make sure that the
medicine is controlling your blood sugar before you try to get
pregnant.

Do you take insulin? Talk to your doctor before you try
to get pregnant to see if you need to change your dose or how you take it (such
as through an insulin pump or as shots). If you figure out the right dose of
insulin to take before you get pregnant, you are less likely to have problems
with high and low blood sugar during your pregnancy.

Do you take
medicine to treat other problems? Talk to your doctor before you get pregnant
to see if you need to stop or change your medicine.

Do you have
problems from diabetes, such as eye or kidney disease? If you do, being
pregnant can make some of these problems worse. Also, high blood pressure can
create problems for you and affect your baby's growth during pregnancy.

Do you have other children? If so, how did the diabetes affect
your pregnancy?

Do you take a folic acid supplement? Taking a
daily multivitamin or prenatal vitamin with folic acid reduces the chance of
having a baby with a birth defect.

FAQs

What should you do before you get pregnant when you have diabetes?

You can have a healthy pregnancy if your blood sugar is
in a target range before you get pregnant and you don't have
high blood pressure or problems from diabetes, such as kidney disease. Keeping
your blood sugar at a target level lowers your risk of birth defects,
miscarriage, and other problems. (The American Diabetes Association suggests an A1c of less than 7% for most nonpregnant adults.1)

The American Diabetes Association (ADA) suggests the following ranges for women with type 1 or type 2 diabetes who become pregnant:1

A1c: 6% to 6.5%

Before meals, bedtime, and overnight: 60 to 99 mg/dL

1 to 2 hours after meals: 100 to 129 mg/dL or lower

Experts recommend keeping blood
sugar levels in the target range for 3 to 6 months before you get
pregnant. To do this, get plenty of exercise, eat healthy foods, lose weight if
you need to, and take medicine if your doctor prescribes it.

What should you talk to your doctor about?

Medicines

It's important to let your doctor know
if you are thinking about getting pregnant. If you take pills to treat your
diabetes, your doctor may want you to switch to insulin or to a new pill before
you get pregnant. And if you take insulin, your doctor may need to change the
dose or how you take it, such as through an insulin pump or as shots.

You also need to let your doctor know about any medicine you take to
treat other health problems. He or she may have you stop or change your
medicine before you get pregnant if you are taking any medicines that could
harm your baby.

Screening

When
you have diabetes, you need to see your doctor regularly to check for problems
from the disease. It's especially important to do this before you get pregnant.
Screening tests help your doctor look for these problems before any symptoms
appear. This can increase your chance of finding the problem at a more
treatable stage. These tests include:

Blood pressure checks. High blood pressure can
cause problems with the mother and the baby. When blood pressure is very high,
the
placenta may not work well and the doctor may need to
deliver the baby early.

Blood sugar level tests. Your doctor will talk to you about
keeping your blood sugar in a target range at all times before
and during your pregnancy.

What are the risks from getting pregnant when your diabetes is not controlled?

Uncontrolled diabetes increases the risk of
problems for both the baby and the mother.

It
may be disappointing to not be able to have a baby when you want to.

Personal stories

Personal stories about deciding about getting pregnant when you have diabetes

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I have had diabetes for a long time. So when my husband and I started talking about having a baby, I mentioned it to my doctor during my regular checkup. I do a good job of keeping my blood sugar under control. So after doing some tests and adjusting my medicine, my doctor said it was safe to start trying. I got pregnant and gave birth to a healthy baby boy."

— Mandy, age 32

"My life has been pretty stressful, and it has been hard to keep my blood sugar in my target range. I want to get pregnant before I'm too old, but I worry about the risk of birth defects if I get pregnant now. Having a baby is a priority for me, so I talked to my doctor about some specific changes I can make to lower my stress level and focus on my health. I am going to wait for now to see if I can get my blood sugar under control."

— Rachael, age 38

"I have two children, and we want to try for a third. I had diabetes with both my pregnancies. My doctor worked with me to set target blood sugar levels before each pregnancy, and everything went smoothly. I am now 5 months pregnant and feeling good."

— Janelle, age 34

"Recently I was diagnosed with type 2 diabetes. I am newly married, and my husband and I want to have a family in the next few years. I am taking medicine and trying to eat right and get exercise so that I will be healthy when we decide that the time is right to start trying to have a baby."

— Christine, age
26

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to try to get pregnant now

Reasons not to try to get pregnant now

I am not worried that my diabetes will cause health problems for my baby.

I am worried that my diabetes may cause health problems for my baby.

More important

Equally important

More important

I want to try to get pregnant now. I don't want to wait.

I want to wait until my doctor says it is safe before I try to get pregnant.

More important

Equally important

More important

My blood sugar levels are under control, and I'm confident that I can keep them controlled.

I want to get my blood sugar levels under control before I try to get pregnant.

More important

Equally important

More important

I'm not worried that getting pregnant now could harm my health.

I am worried that getting pregnant now could harm my health.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Trying to get pregnant now

NOT trying to get pregnant now

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
As long as my doctor says my medicine is controlling my diabetes, it is safe for me to try to get pregnant.

True

False

I'm not sure

You're right. Having your diabetes under control isn't enough. To have a healthy pregnancy, you also need to make sure that you don't have high blood pressure or problems from diabetes, such as kidney disease.

2.
My blood sugar levels should be in a target range for at least 3 months before I get pregnant.

True

False

I'm not sure

That's right. You should have blood sugar levels in a target range for at least 3 months before you get pregnant. This lowers the chance of birth defects, miscarriage, and other problems.

3.
Before I get pregnant, I need to see my doctor regularly to check for diabetes complications, such as eye or kidney disease.

True

False

I'm not sure

That's right. When you have diabetes, you need to see your doctor regularly to check for complications from the disease. These problems can get worse during pregnancy.

Decide what's next

1.
Do you understand the options available to you?

Yes

No

2.
Are you clear about which benefits and side effects matter most to you?

Yes

No

3.
Do you have enough support and advice from others to make a choice?

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